Q&A with the Nursing Site's Kathy Quan, RN, BSN, PHN: Thoughts on Home Health, Hospice, and Nursing in General interviews home health and hospice nurse, Kathy Quan, RN, BSN, PHN. Kathy has more than 30 years of experience in nursing. She was also the Guide to Nursing at and is the founder and editor of the popular nursing blog, The Nursing Site.

Below, Kathy talks about her experience in nursing and what students should expect from the career.

Q: What is your current position?

I am a hospice nurse and quality assurance specialist.

Q: What is your nursing background?

I've been in home health and hospice for over 30 years, with a couple of breaks in between. I've worked my way up from a field nurse to a nursing supervisor, staff educator, and now, the quality assurance role that I'm in.

Q: What should nurses seek from their educational experiences?

Nursing is a very intense program, and it's going to take a lot of studying and a lot of work. You need to be able to understand how flexible a program is and know about the faculty. Sometimes, [the instructors] have PhDs, but may not have worked a day on a floor or in any kind of clinical setting. They might not make the best teachers. Get a good idea of the faculty and the clinical settings. How much time are you going to spend in the clinical aspect? What other specialties besides hospital care are they going to offer in the program?

Q: Can you describe the skills needed in some of the different nursing roles?

In home health you kind of have to be a jack-of-all-trades because you're out there on your own. There's nobody down the hall you can grab and say, "Come, help me!" As a nursing supervisor, you're backup support over the phone [for nurses] when they have a question or problem. You have to have a lot of self-confidence. You have to be resourceful. In the home, you may have to boil some water in order to clean off your instruments, for example.

Q: When new nurses are starting out, what should they expect from an average day?

One thing I think it's important for a new nurse to remember is that the first day or week, you're going to feel like, "Oh my God, I've forgotten everything I've learned!" It will all come back to you. You're going to have to give yourself some time and be patient. Days are going to be very different than they were in your clinical studies. In clinical, you may have had only one or two patients, and as a nurse you're going to have maybe six to eight. It's going to be hectic and crazy, and you're going to have a lot more patients than you thought you could ever get through. But, it will get better.

Q: What are some of the challenges nurses face in general?

We're in another horrible, tremendous nursing shortage. To some extent, you may not believe that because new nurses are having a hard time finding a job. Hospitals are hiring, but they want experienced nurses, and they want nurses with more education. They're looking for a BSN or MSN-prepared nurse. And new grads out of an ADN program, or even out of a BSN program, are going to have a harder time finding a job right now. A lot of nurses have come out of retirement because of the economy, or have delayed their retirement.

Q: What are the benefits of specializing?

Hospice is a unique little area because we're helping patients at the end of their life. I've found that you have to really glean your own rewards in nursing. People aren't necessarily going to pat you on the back. Watching a patient pass on with the family able to say their goodbyes - having it all come together as a peaceful situation - can be a really heartwarming experience for a nurse.

Q: Are there any specific traits that work well in this career?

You've got to be a compassionate and patient person. You have to want to help people feel better and achieve better outcomes for themselves in a health setting. The media always seems to portray nurses as being young girls looking to find a doctor husband. Nursing is hard work; it's emotionally challenging and physically demanding. You have to be willing to put in the time.

Q: How has nursing changed in the past few years?

Nursing has become a lot more technical in patient care as well as with the equipment. A lot of nurses are using PDAs (or smartphones). You have everything right there at your fingertips. Nurses are doing their charting in the hospital on their laptops. They're reading a barcode on wristbands now to identify patients, in addition to the other information given. We're reducing a lot of the errors with medications and procedures.

Q: What do you see for the future of nursing?

With health care reform, and just in general, nurses are doing a lot more teaching for patients. That's going to be a growing role, so we need to have a lot more tools and a lot more technology.

Q: What advice do you have for new nurses?

One thing you need to know is that you're not going to learn everything you need to know from school. You're going to learn a lot of things on the job; nursing is a lifelong learning experience. The education process can be a very difficult one. You're not always going to have an opportunity to have every single procedure available to you. You need to keep your eyes and ears open. If you hear of something that [you're interested in] going on, on the floor, say, "I would love to observe that opportunity. I'd love to try to participate, if possible." And, be a sponge. Go out there and learn everything that you possibly can.

Q: Any other recommendations for aspiring nurses?

Nursing is probably one of the greatest professions that you can consider. But there's always going to be [someone to ask you]: "Why didn't you want to be a doctor?" You have to understand what [nursing] is and why you want to go into it.

It's a wonderful profession, but there are times when you're going to get tired of it and need to walk away. There's a wealth of opportunity out there, but too many nurses get stuck. There are a lot of things that you can do. Ask for an opportunity, and I think a lot of people will give it to you.